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Michigan rates for HCPCS 97155

Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes

Facilitymedian $19 · 10th–90th $19–$330%20%40%90th$19Professionalmedian $19 · 10th–90th $17–$850%20%40%10th90th$19$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $89.13
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $23.44 / $24.55
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $28.18 / $33.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $26.92 / $33.11
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $22.39 / $33.11
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $22.39 / $37.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $26.30 / $40.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $208.93
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $36.31
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $24.55 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $20.89 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $38.90 / $50.12